In an article by Morten Dige in the Scandinavian Journal of Occupational Therapy, a value theory for occupational therapy is developed where the goals of occupational therapy, i.e. activity and participation, are seen as valuable in themselves. Such a value theory opens up for a paternalistic approach towards the person in need of occupational therapy who risks being excluded from certain types of activities and the theory even risks excluding certain groups of persons. In this comment to Dige, it is argued that adopting a more subjective approach to value, in which activity and participation are instrumental to values such as subjective well-being or the fulfilment of desires, the risk of inherent paternalism and exclusion is minimized. Moreover, activity and participation can still maintain their central role as goals of occupational therapy.